| 11/04/2015 |
| 07:19:04 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| KAPSOFF, KEELY, | TA-645719 | R | 29.99 | 5111********6514 | 063334 | 11/04/15 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 29.99 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 29.99 |